‘One Size Does Not Fit All’

At two forums on healthcare reform at the NAACP’s Centennial Convention Saturday, panelists presented a slew of statistics that rank African Americans with the highest prevalence, incidence, and mortality rates for diabetes, AIDS, cancer, and other diseases.

“[People] like you and me are falling through the cracks,” said Roslyn M. Brock, vice chairman of the national board of directors at the NAACP.

“Social and economic determinants shape health equity,” said panelist Shonta Chambers, a representative of the American Heart Association, who says access to care and treatment disparities are inclusive of a person’s environment and other social determinants. “We would be remiss to talk about health disparities and not talk about communities.”

Chambers believes that African Americans must diversify the discussion surrounding healthcare by including policy and research on land use, agriculture, infrastructure, transportation, and economic development and how these topics affect health disparities.

“Racial and ethnic minorities get left out all of the time,” says Hilary Shelton, senior vice president for advocacy and the director of the NAACP Washington bureau, in an interview after the session. “Comprehensive healthcare must be inclusive. One size does not fit all.”

Health disparities are not just about patient care, he says, suggesting that some of the solutions might involve reducing, for example, high incarceration and high unemployment.

As Congress gets ready to vote on a new healthcare reform bill, Shelton recommends that more focus be added on prevention.

“There must be a system in place that is totally inclusive and that educates people about how to control their environments and seek healthcare before they get sick,” Shelton says.

2 Responses to ‘One Size Does Not Fit All’

Social determinants of health, while important, cannot become so broad as to cloud the depth of the health disparities conversation.

Rather than take the health disparities discussion outside of the context of health (which by its nature it is) focus it and drive it deeper. Otherwise for most decision makers it could be overwhelming, especially since they often consider things within a context of categorical silos where funding is concerned.

Until these funding silos change (which will not be in our lifetime more than likely) we have to go deeper vs. wider.

For example, rather than making the issue of health disparities a marginalized “minority” issue, frame it in the context of health care cost for businesses with a growing number of employees experiencing disparities, from ethnic minorities to the LGBT community through disabled Americans.

Or consider framing the issue as a quality one or as I believe: health disparities are quality disparities.

If we continue framing health disparities in ways that don’t clearly articulate that they affect everyone directly or indirectly, this monumental issue will remain marginalized with severe consequences on many levels for all affected. Which translates into: we are ALL affected!